Discriminative Nursing Care Practices Towards Patients with Opioid Use Disorder in the Hospital Setting: How Knowledge and Social Attitudes Impact Care Delivery

Discriminative nursing care (DNC) practices towards patients with opioid use disorder (OUD) is a current phenomenon negatively affecting patient care and patient outcomes. It leads to delays in care, insufficient pain control, and feelings of guilt and shame, and it is linked to self-isolation, social isolation, social rejection, and even unemployment and housing disruption which perpetuate a dangerous cycle of inequity that is hard to overcome. In some cases, OUD stigmatization even increases morbidity and mortality rates. OUD stigmatization and discrimination are real problems in today’s health care climate due to the vast number of people affected by OUD and the negative outcomes associated with the stigmatization process. An integrative review following Whittemore & Knafl’s (2005) updated methodology was conducted to ascertain the state of the science of this phenomenon. Four themes emerged in this review, and the theme nurses’ lack of knowledge was identified as the main facilitator of DNC towards those with OUD. Grounded in the Health Stigma and Discrimination Framework, which was operationalized as a middle range nursing theory, a secondary analysis of data from the Perception of Opioid Use Survey was conducted to determine the association between nursing knowledge, along with other variables, and nurses’ perceptions of their abilities to provide equitable care to those with and without OUD. Important findings were discussed, and implications and recommendations for future nursing research, education, nursing practice, and policy were offered. Qualitative case study research related to nurses’ age, years of experience in nursing, and their perceptions of their abilities to provide equitable care to patients with stigmatized health conditions is a key recommendation for subsequent research.